Supraventricular Tachycardia as a Cardiopulmonary Stress Response to Traumatic Chylopneumothorax and Diaphragmatic Hernia: A Case Report

Authors

DOI:

https://doi.org/10.30701/ijc.2041

Keywords:

Arrhythmia, Supraventricular tachycardia, Thoracoabdominal trauma, Chylopneumothorax, Diaphragmatic hernia

Abstract

Background: Supraventricular Tachycardia (SVT) is a heart rhythm disorder characterized by an increased heart rate originating from the Atrioventricular (AV) node in the atrium. It is characterized by an Electrocardiography (ECG) tracing showing a narrow QRS complex (<120 ms) and a rapid, regular heartbeat. Blunt trauma to the thoracoabdominal region can cause diaphragmatic hernia and chylopneumothorax. Both conditions could escalate the progression of cardiopulmonary stress, such as heart rhythm disturbance (arrhythmia).


Case Illustration: We report a case of a 30-year-old woman who presented to the Emergency Room with sudden palpitations 1 day ago. Physical examination revealed a restless appearance (Glasgow Coma Scale [GCS] E4V5M6), blood pressure 146/94 mmHg, pulse rate 155 beats per minute (bpm), respiratory rate 30 bpm, temperature 36 °C, and saturation 95% on room air. In the thoracic region, dull percussion was found in the lower left hemithorax, decreased left lung base sounds, bowel sounds were heard, and tenderness was observed in the left costovertebral angle in the abdominal region. ECG examination showed the presence of SVT with a heart rate of 176 bpm. The patient was initially managed by performing a vagal maneuver, but it failed. The patient was then transferred to the Intensive Care Unit (ICU), underwent further diagnostic examinations, and received further therapy.


Conclusions: SVT in patients with thoracoabdominal trauma is not a primary cardiac abnormality, but rather an indicator of life-threatening trauma-related cardiopulmonary compromise. Clinicians need to recognize the importance of timely and appropriate intervention, along with adequate cardiopulmonary support, to improve patient outcomes.

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References

1. Patti L, Horenstein MS, Ashurst JV. Supraventricular Tachycardia. [Updated 2025 Feb 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441972/.

2. Jowers, J.; Van Derveer, K.; Moore, K.; Harshaw, N.; Reichert, J.M.; Karr, H.; Khaliq, U.; Cziperle, D.J.; Perea, L.L. (2025). Incidence and Risk Factors of Developing a Dysrhythmia After Blunt Thoracic Trauma. J. Clin. Med. 14, 6253. https://doi.org/10.3390/jcm14176253.

3. Massari F, Scicchitano P, Potenza A, Sassara M, Sanasi M, Liccese M, Ciccone MM, Caldarola P. (2025). Supraventricular tachycardia, pregnancy, and water: A new insight in lifesaving treatment of rhythm disorders. Ann Noninvasive Electrocardiol; 23(3):e12490.

4. Harvey, C., Shin, H., Martin, S., & Perea, L. (2024). Traumatic chylothorax following blunt thoracic trauma. Trauma case reports, 54, 101101. https://doi.org/10.1016/j.tcr.2024.101101.

5. Abdullah, H. O., Kakamad, F. H., Ahmed, H. K., Amin, B. J. H., Abdullah, H. M., Mohammed, S. H., Abdalla, B. A., Ahmed, S. M., Hassan, M. N., Abdalla, S. S., Mahmood, Y. M., Najar, K. A., Kakamad, S. H., & Abdalla, B. A. (2025). Blunt Chest Trauma and Chylothorax: A Systematic Review. Journal Home Page Systematic Review. Judi Clin. J, 1(1), 27. https://doi.org/10.70955/JCJ.2025.4.

6. Giuffrida, M., Perrone, G., Abu-Zidan, F. et al.(2023) Management of complicated diaphragmatic hernia in the acute setting: a WSES position paper. World J Emerg Surg 18, 43. https://doi.org/10.1186/s13017-023-00510-x.

7. Bhatnagar, M., Fisher, A., Ramsaroop, S., Carter, A., & Pippard, B. (2024). Chylothorax?: pathophysiology, diagnosis, and management — a comprehensive review. 16(2), 1645-1661. https://doi.org/10.21037/jtd-23-1636.

8. Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A., 3rd, Field, M. E., Goldberger, Z. D., Hammill, S. C., Indik, J. H., Lindsay, B. D., Olshansky, B., Russo, A. M., Shen, W. K., Tracy, C. M., Al-Khatib, S. M., & Evidence Review Committee Chair‡ (2016). 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation, 133(14), e471-e505. https://doi.org/10.1161/CIR.0000000000000310.

9. Brugada, J., Katritsis, D. G., Arbelo, E., Arribas, F., Bax, J. J., Blomstrom-Lundqvist, C., Calkins, H., Corrado, D., Deftereos, S. G., Diller, G. P., Gomez-Doblas, J. J., Gorenek, B., Grace, A., Ho, S. Y., Kaski, J. C., Kuck, K. H., Lambiase, P. D., Sacher, F., Sarquella-Brugada, G., … Gupta, D. (2020). 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. European Heart Journal, 41(5), 655-720. https://doi.org/10.1093/eurheartj/ehz467.

10. Sybrandy KC, Cramer MJ, Burgersdijk C. (2003). Diagnosing cardiac contusion: old wisdom and new insights. Heart. 2003;89(5):485-489.

11. Antzelevitch, C., & Burashnikov, A. (2011). Overview of Basic Mechanisms of Cardiac Arrhythmia. Cardiac Electrophysiology Clinics, 3(1), 23-45. https://doi.org/10.1016/j.ccep.2010.10.012.

12. Rosso, R., & Kistler, P. M. (2010). Focal atrial tachycardia. Heart (British Cardiac Society), 96(3), 181-185. https://doi.org/10.1136/hrt.2008.143552.

13. Idris, K., Sebastian, M., Hefny, A. F., Khan, N. H., & Abu-Zidan, F. M. (2016). Blunt traumatic tension chylothorax: Case report and mini-review of the literature. World journal of clinical cases, 4(11), 380-384. https://doi.org/10.12998/wjcc.v4.i11.380.

14. Alp, H., Baysal, T., & Karaarslan, S. (2014). Supraventricular tachycardia due to blunt chest trauma in an adolescent. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES, 20(3), 211-213. https://doi.org/10.5505/tjtes.2014.90337.

15. Clancy K, Velopulos C, Bilaniuk JW, et al. (2012). Screening for blunt cardiac injury: An Eastern Association for the Surgery of Trauma practice management guideline. Journal of Trauma and Acute Care Surgery. 2012;73(5 Suppl 4):S301-S306.

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Published

2026-10-25

How to Cite

Musa, I. P. B., Pratiwi, I. K., Patadungan, W., Tasya, N., & Adriani, N. A. (2026). Supraventricular Tachycardia as a Cardiopulmonary Stress Response to Traumatic Chylopneumothorax and Diaphragmatic Hernia: A Case Report. Indonesian Journal of Cardiology. https://doi.org/10.30701/ijc.2041

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Online First

Section

Case Reports

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